Online aligners | British Dental Journal

Sir, I recently attended my orthodontic study day and one of my colleagues had brought our attention to a TikTok video in which the content creator demonstrated to his viewers how to make multiple sets of clear aligners at home, using a software program, a 3D printer and a dental vacuum forming moulding machine. He has also offered to provide clear aligners for his viewers and included a payment link to a ‘video course tutorial’ for those interested in making their own aligners. To my surprise, the video has over 9.3 million views and over 10% of viewers have reacted positively to the video (1.1 million likes).

It is extremely worrying to see that the transition of remote orthodontics has now extended from branded retailers to home providers. On this occasion, it is clear that the content creator and his supporting audience have failed to perceive the potential catastrophic consequences that these self-made aligners can cause to dentitions, including pulp devitalisation, root resorption, periodontal damage and unstable occlusion. However, this situation is very much influenced by the fact that orthodontic treatments with clear aligners are often advertised and perceived with an oversimplified view.

The GDC ‘direct-to-consumer’ orthodontic treatment statement published in May 2021¹ clearly stated that ‘the suitability of a proposed course of orthodontic treatment must be based on a full assessment of the patient’s oral health’ and ‘these services fall within the legal definition of dentistry so can only be performed by dentists and dental care professionals who are registered with the GDC.’ Nevertheless, at this point in time, there is an apparent lack of public awareness of the risks of DIY orthodontics. As opposed to the extravagant advertisements placed by retailers and content creators, the response from our profession seems relatively subdued.

As dental practitioners, we have a duty of care to educate patients and protect the public from suffering dental harm resulting from misleading resources. However, considering the strong influence that social media and retail advertisements have on our community, predominantly relying on practitioners to deliver information and clarification to individual patients will no longer be a sustainable approach.

I therefore urge our peers, fellows and colleagues to actively consider the need to publish a prompt statement, to specify the potential complications of DIY orthodontics and to respond to the public as a professional body, in order to safeguard dental public health, uphold standards and maintain the integrity of our profession.